Rights & Access
California (story via ANCOR’s Open Minds subscription, 07/28/19) In a recent report by Public Counsel, the state’s twenty-one regional centers serving individuals with I/DD consistently spent fewer resources on children and youth who are Black/African American or Hispanic than they do for Caucasian children. For fiscal year 2017-2018, the report found an average per capita spending of $3,506 more for White children than for Hispanic children.
Kentucky – (Bowling Green Daily News, 07/29/19) The legislature passed Senate Bill 1, which will place more counselors in public schools (at a rate of one counselor to every 250 students) with a focus on addressing students’ traumatic experiences and creating trauma-informed school plans. Terry Brooks, director for Kentucky Youth Advocates, believes that the way to pay for this enhanced services is through amending the state’s Medicaid plan and allowing schools to be reimbursed directly by Medicaid and by counting funds already spent on health services toward the required Medicaid match.
National (apnews.com, 07/25/19) While at a meeting of the National Governors’ Association, several states consider next steps if the 5th Circuit Court of Appeals upholds the lower court, Texas-based, ruling that the ACA is unconstitutional. A coalition of twenty Democratic-leaning states led by California filed the appeal to the lower-court ruling in an effort to keep the ACA intact. A number of state administrations have sought to have laws enacted that would maintain a number of protections currently afforded under the ACA such as the inability of insurance carriers to deny coverage for pre-existing conditions, this in an effort to safeguard healthcare access.
Medicaid, Medicaid expansion, MLTSS
Florida - (story via ANCOR’s PoliticoPro subscription, 7/25/19) In a report from the office of the HHS Inspector General, the state of Florida could be on the hook to repay Medicaid $436 million in funds improperly paid to the country’s largest public hospital. In a February memo former CMS director Mary Mayhew, now serving as Florida’s Secretary for Healthcare Administration, states "Any recoupment by the federal government will severely harm Jackson Memorial Hospital, and most importantly, the Medicaid and uninsured patients that rely on Jackson Memorial for life-saving care." It was found that between the years of 2010 – 2014, the state’s Medicaid program wrongly paid Jackson Memorial Hospital located in Miami-Dade county hundreds of millions of dollars that weren’t allowed under the terms of the Low-Income Pool (LIP) designed to reimburse hospitals for treating low-income individuals.
Missouri – (Kansas City Star, 07/25/19) Republican House Speaker Elijah Haahr asks Governor Parson why 120,000 people including 95,000 children have been dropped from the Medicaid rolls over the last 18 months. The Speaker promises an legislative investigation (as requested by House Democrats) if the answers he receives are insufficient. The administration sites an “improving economy” as the cause for a decreasing need for public health coverage. Democrats and analysts are skeptical of the administration’s rationale given that Missouri’s enrollment was the third-highest in the nation just last year. Instead they are looking to a recent change in the state’s computer system and outdated contact info of enrollees as more likely causes for people being removed from the rolls.
New Hampshire – (story via ANCOR’s PoliticoPro subscription, 7/22/19) New Hampshire is one of nine states that have received approval from CMS to implement work requirements as a condition of receiving health care through Medicaid expansion and Governor Sununu has argued that the requirement of 100 hours per month (unless otherwise exempted) is necessary to control costs. However three advocacy groups have filed a legal challenge in US District Court and it will be heard by the same judge that ruled against similar rules in Arkansas and Kentucky. “The legal challenge was brought by the National Health Law Program, New Hampshire Legal Assistance and the National Center for Law and Economic Justice, who contend the administration erred because the policy doesn't advance Medicaid's purpose of providing health coverage to the poor.” New Hampshire work rules are due to go into effect on October 1st but can be postponed until July 2021. In a PoliticoPro update on 7/23/19, the Trump administration asked the federal judge to delay the ruling on this case stating that a ruling would be premature since the Sununu administration has delayed implementation from the original time line.
Oklahoma – (Insurance News Net, 07/27/19) While Medicaid expansion did not make it out of Senate committee this session, it seems likely that ongoing attention will be paid to the issue. Legislative supporters believe that they must get it done. This year there was $140 million placed in the “governor’s slush fund” which if applied to Medicaid expansion, would have brought the state up to $1 billion in federal funds. Currently the group Oklahomans Decide Healthcare has launched a campaign to collect the 178,000 signatures needed by October 28th to place Medicaid expansion on the ballot in 2020.
Utah – (The Hill, 07/27/19) The Trump administration has announced that it will disallow Utah’s request for a limited expansion of Medicaid but with the full federal funding at 90% of the costs. Utah voters approved by ballot an expansion that would have covered 150,000 people at up to 138% of poverty level. It would have been paid for by an increase in the sales tax with Medicaid funding 90% of the total. Under the legislatively modified plan, the state will only cover up to 100% of poverty (about 48,000 fewer people will be covered) and it will cost the state $50 million more than the full expansion would have cost.